Predictors of Inflammation in a Cohort of Bolivian Infants and Toddlers

• Type of Material: Article
• Authors: Rachel M. Burke, Emory University; Parminder Suchdev, Emory University; Paulina Rebolledo, Emory University; Anna M. Fabiszewski de Aceituno, Emory University; Rita Revollo, Servicio Departamental de Salud; Volga Iniguez, Universidad Mayor de San Andrés; Mitchel Klein, Emory University; Carolyn Drews-Botsch, Emory University; Juan Leon, Emory University
• Language: English
• Date: 2016-10-05
• Publisher: American Society of Tropical Medicine and Hygiene
• Publication Version: Final Published Version
• Copyright Statement: © 2016 by The American Society of Tropical Medicine and Hygiene.
• Final Published Version (URL): http://dx.doi.org/10.4269/ajtmh.16-0292
• Title of Journal or Parent Work: American Journal of Tropical Medicine and Hygiene
• ISSN: 0002-9637
• Volume: 95
• Issue: 4
• Start Page: 954
• End Page: 963
• Grant/Funding Information: Financial support: This work was supported in part by NIH-NIAID K01 grant (1K01AI087724-01) grant; PHS Grant UL1 TR000454 from the Clinical and Translational Science Award Program, National Institutes of Health, National Center for Research Resource; the Emory + Children's Pediatric Center Seed Grant Program; the National Institutes of Health/NIAID grant U19-AI057266; the International Collaborative Award for Research from the International Pediatric Research Foundation; the Laney Graduate School of Emory University; NIH T32 training grant in reproductive, pediatric and perinatal epidemiology (HD052460-01); Burroughs Wellcome Fund's Molecules to Mankind Program (M2M); and the NIH T32 Vaccinology Training Program (T32AI074492).
• Keywords: METABOLIC SYNDROME; Life Sciences & Biomedicine; Public, Environmental & Occupational Health; PUBLIC-HEALTH PRACTICE; LIFE-STYLE; CARDIOVASCULAR-DISEASE; MIXED-EFFECTS MODELS; Tropical Medicine; CHILDREN; Science & Technology; CDC/AHA WORKSHOP; INSULIN-RESISTANCE; C-REACTIVE PROTEIN; YOUNG-ADULTS
• Research Categories: Health Sciences, Public Health; Health Sciences, Epidemiology

Abstract

Inflammation has been associated with cardiovascular disease and other health outcomes in children and adults, yet few longitudinal data are available on prevalence and predictors of inflammation in infants. We aimed to identify the prevalence of inflammation in a cohort of Bolivian infants and estimate its association with acute (recent illnesses) and chronic (overweight, stunting) morbidities and potential pathogen exposure (represented by water, sanitation, and hygiene [WASH] resources). We measured plasma concentrations of two acute phase proteins (C-reactive protein [CRP] , marking acute inflammation, and alpha(1)-acid-glycoprotein [AGP], marking chronic inflammation) at three time points (target 2, 6-8, and 12-18 months). Of 451 singleton infants enrolled in the parent study, 272 had the first blood draw and complete data. Anthropometry and sociodemographic and recent illness data (2-week recall of cough, diarrhea, and fever) were collected at each visit. Inflammation was defined as CRP > 5 mg/L or AGP > 1 g/L. The prevalence of inflammation increased from early infancy (3% at first blood draw) to later infancy (15-22% at later blood draws). Recent cough, recent fever, and age in months were significantly associated with relative increases in CRP (7-44%) and AGP (5-23%), whereas recent diarrhea was only significantly associated with an increase in CRP (48%). Neither anthropometry nor WASH was significantly associated with inflammation. Results confirm the role of recent acute illness in inflammation in infants, and indicate that adiposity and WASH are not as important to inflammation in this age category.